HomeMy WebLinkAboutSUBMITTED PAPERSt
i7
OFFICE USE ONLY: '.~ `-
DATE FILED: 3 ' p y�
PLAN REVIEW FEE: RECEIPT NO.: ` M o PERMIT NUMBER: �^ 11 1'/ ®0 0q
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
SCANNED 2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
BY 772462-1553
�f. Lucie County j—', v2CGC.
APPLICATION for BUILDING PERMIT -
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS: 6 /% La-S
2. PROJECT NAME: &5 �iy►� SITE PLAN NAME:
3. PROPERTY TAX ID #: 3 Y/ f - 0 (k
4. LEGAL DESCRIPTION (attach extra sheets if necessary): LQ S �! M� d-) ZOT d- /
l0 -ffo
5. PLAT BOOK 1��� 6. PAGE NO. 7. BLOCK NO. S. LOT NO. d /
9. PARCEL SIZE (ACRES/SQ FT.): -a 1 Qerf-s LOTDMNSIONS: 75'k /Od,
i0. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: A- 50 ,lt1
^ 11. SETBACKS (ACTUAL) FRONT: as y BACK: 3.b RIGHT SIDE: LEFT SIDE: /3•
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
(NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE:
14. SQ. FT OF CONSTRUCTION:
16. VALUE OF CONSTRUCTION: $ 3i DOS • I'll
15. SF. FT 1 st FLOOR: /-7 V
The value of construction is used to determine the amount of permit fees to be assessed. St Lucie County reserves the right to question and/or modify the indicated
value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
UPDATED 6/25/09
6 1
OWNER INFORMATION,
/6a NAIL: r, Q• n
ADDRESS: zAic
a�i►�lL•
CITY: 10 L / / STATE: & ' ZIP:
PHONE (DAYTIME): `' '� '� ' `� Email: 0 h f06 Qi !�� f7�2 i!• OYh
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTEVIE):
CONTRACTOR INFORMATION - O ARW
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #:
BUSINESS NAME: _/7 i�l J We I2
QUALIFIERS NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTMIE): FAX NO.. Email:
ARCHIT/BNGINEER:
ADDRESS:
CITY:
PHONE (DAYTRv E): (__)
BONDING COMPANY:
ADDRESS:
CITY.
STATE:
STATE:
MPI
MORTGAGE LENDER: /J-& I
ADDRESS:
CITY: STATE: ZIP:
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification
it will be voided and returned to you by mail.
r Planning & Development Services Permit 1 •
Building & Code Regulation Division
2300 Virginia Avenue r
Fort Pierce, FL 34982 i
Phone: (772) 462-1553 Fax: (772) 462-1578 `
Address NRM
LAS PALMAS WAY Owner(s) FRANCES GASKIN
IE 34952 Historic No Jurisdiction St. Lucie County
`7 Parcel # 5-000/1 S/D Las Palmas Block Lot # 21
FLU Zoning RM-5 Flood Mar 280E Flood Elevation Flood Zone X
Add A New Permit —
"APPLICATION INFORMATION Property Maintenance
Application Type Master Permit w/subs Status Void
0509-0279 Activity Type New
Expiration 09/20/2007
® Other - Specify
501 Permit Type Building Residential (SFR) Date Applied 09/09/2005 Taken By 'serranob
Location Mainland Date Issued 03/29/2006 Issued By dpelton
i.....
lat Fee Valuation Date Finaled Posted By
Date Voided Please explain in Additional Comme.
i Job Address 6417 LAS PALMAS'WAY
Category Type
Contractor
jProperty Owner
Name
{ Property Owner
''"
Contractor
Business
Address
Email
Open Contractor .
Registration
Phone (772) 418-1988 ext
Fax ( ) -
Mobile ( )
PagerrSUB TRADE PERMITS Attach Sub
Trade
Sub -Trade Permit Permit Type Electrical ub Trade Status Void
0509-0279-01 Contractor 21355 FLAXMAN MICHAEL Taken By serranob
i. 0509-0279-01 EP
)0509-0279-02 PP Company ENERGIZED ELECTRICAL SERVICES INC Date Applied 09/09/2005
0509-0279-03 ME Phon( ( ) _ Issued 03/29/2006
"-" - --- - Owner / Buildier Issued By dpelton
Expiration Finaled
Sub -Trade Job Description
•: 03/12/2007
Finaled By
Units 1 OOi ; .. Floors M Buildings ;1; #Bedrooms F3_� #Bathrooms 2.0
Total Sq. Ft. 2,423.00 Min Flood Elevation �� Flood Map 280E Flood Zone
FCC 101 Single Family Detached an NOC Required ® NOC Received ® NOC Expiration
Setbacks Front 25.00 Back 36.70 Left Side 13.60 light Side 13.70
Job Description
Additional Info
CONSTRUCT NEW SINGLE FAMILY RESIDENCE - 312
Please include the date and your name when adding rntormarion.
6/28/2010 Renewal fee of $80.00 to final///Ken
4-16-2010 renewal fee 80.00 down to final- A Humphrey
9/18/07 courtsey call - spoke to noreen / contractor- permit to be expired on 9/20/07 . bacounsellor
2/27 CHANGE OF CONTR. FOR PLUMBING AND AC, LB
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
'
Aat�i'r,.
Fort Pierce, FL 34982
Phone: (772) 462-2172 Fax: (772) 462-6443
Inspections f`
Onlinb address:
http://www.stlucieco.org/planning/permitting.htm
Quick Links
Permit Status Lookup
Online Building Inspection System —
x� _» m : tF"
0509-0279 Job Address 6417 LAS PALMAS WAY 'ermit Type .Building Residential (SFR)
t , .... ...... ...._.... _..... _...................
— .
L1 pplication Type 'Master Permit w/subs Other
Expired Activity Type New i Stories 1 Inspection Area
:, -`Job Descri tion
`� ONSTRUCT NEW SINGLE FAMILY RESIDENCE - 3/2
ij.Pfoperty Owner Name NGG POINT LLC Phone�-
Business Name
W'CTIQNS Con#Tactors »� Fees ?� Al, (q)
tly °IrlspecEion Schedule Report�and ,Ca%ds ispecfio�n`-SuhlmaryrERepo
Notes
"1/25/07 PER CHRIS L AND RAY WAZNY AT THIS TIME WE ARE NOT
;HARING THE 100.00 30 DAY EXPIRED FEE'S UNTIL FURTHER NOTICE.
`^ ^'
Date
Scheduled
Prioritl Status
i
172
Hurricane Panels (shutters)
8
a
172
Hurricane Panels (shutters)
8
Max Expiration Date 09/20/2007
Inspector (Code)
Inspector Date Inspected
'li'annon
�;..;
Boone
03/30/2007
261
30 Day Expired
8
Pending
_.
804
Driveway Bldg
8
808
Landscaping/Trees
8
�:-.,•
996
Final Termite Treatment
8
;.<
999
Final Inspection
8
821
Solid Waste
8
a' l`nnon Boone
07/25/2006
425
Sewer Connect
0
Approved
Ken Arnold
07/25/2006
07/24/2006
425
Sewer Connect
0
Disapproved
Ken Arnold
07/24/2006
04/07/2006
104
Compaction Test
1
Approved
Peggy Billing
04/10/2006
04/07/2006
105
Form Board Survey
1
Approved
Lynn Swartzel
04/07/2006
ii.",V Z;Access
04/07/2006
420
Plumbing Rough
1
Approved
Greg Smyth
04/07/2006
,..
IVP!Access
04/07/2006
427
Temp.Toilet/Temp Culvert
1
Approved
Greg Smyth
04/07/2006
ia: <f2*Access
04/13/2006
103
Eufer Ground
2
Approved
Greg Smyth
04/13/2006
v'R Access
04/13/2006
115
Slab
2
Approved
Greg Smyth
04/13/2006
Access
04/13/2006
121
Termite Spray
2
Not Required
Greg Smyth
04/13/2006
a 1R Access
04/20/2006
118
Column
3
Approved
Greg Smyth
04/20/2006
iFVRAccess
04/20/2006
128
Bond Beam
3
Approved
Greg Smyth
04/20/2006
k'v!RAccess
05/11/2006
133
Window/Door Bucks
4
Approved
Steve Brasda
05/11/2006
';•� �R=Access
05/11/2006
134
Roof Sheathing
4
Approved
Steve Brasda
05/11/2006
05/30/2006
136
Roof Dry-in/Tin Tab
4
Approved
Shaun Milligan
05/30/2006
A 0711
Access
05/11/2006
137
Strapping
4
Approved
Steve Brasda
05/11/2006
./RAccess
05/11/2006
145
Truss Drwg
4
Approved
Steve Brasda
05/11/2006
I'L`
06/09/2006
259
Power Release Form
4
Approved
Karen Neal
06/09/2006
06/30/2006
127
Mullion
5
Not Required
Dave Johnson
06/30/2006
06/30/2006
135
Wall Sheathing
5
Approved
Dave Johnson
06/30/2006
06/30/2006
148
Window/Door Attachment
5
Approved
Dave Johnson
06/30/2006
1 .,.
06/30/2006
650
Frame -all
5
Cancelled by Building DeK
Peggy Billing
06/30/2006
06/30l2006
154
Bora Care Treatment (Termit
5
Approved
Dave Johnson
06/30/2006
06/30/2006
140
Construction Rough Framing
5
Approved
Dave Johnson
06/30/2006
06/30/2006
238
Electric Rough
5
Approved
Dave Johnson
06/30/2006
06/30/2006
351
Mechanical Rough -Inducts)
5
Approved
Dave Johnson
06/30/2006
06/30/2006
423
Plumbing Top Out
5
Disapproved
Dave Johnson
06/30/2006
,,
07/10/2006
423
Plumbing Top Out
5
Approved
Greg Smyth
07/10/2006
Comment;
project located at
PLANNING & DEVELOPMENT SERVICES DIVISION
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Ave
Fort Pierce, FL 34982
BUILDING PERMIT
jJ SUB -CONTRACTOR SUMMARY
will be using the following sub -contractors for the
i;� � �
- (Street
wtao
or Property Tax 0 #)
It is understood that N there is any change of status regarding the participation of any of the sub -contractors
listedbelow, I will .immediatelyadvise the Building and Zoning Department of St. Lucie County.
Name of +Company/Contractor"" '-- _
St. Lucie County/
'"-`TState of- oxi a ,— --,
License Number
Trade
Electrical
e,
Plumbing
?`✓ -' ``""�"
11VAC/
Mechanicalr~
Roofing��
Gas
A.v v,,VJ-17T -TTO AwTr V.
PE111
ISSUE DATE:
NUMBER:
PLANNING & DEVELOPMENT
&.,CODE MENT SERVICES DEPARTMENT
J�Z PLAN_
REGULATIONS DIVISION
r,—M, rz'n[_
Y. BUELDINGfKMd1T
--'*COUNT AGREEMENT
i SUB -CONTRACTOR F L P R I D A --- ----- ------------ --
f participation with the
it 'is understood that, if 'there is any change 0 status -regarding Mg Our PaFtic
above mentioned project, I Will immediately advise the Building and Zoning Department
of St. Lucie County by personally filing a Change of Contractor notice. (Forin: SLCCDV
No. 004-00)
BUSINESS ,QUALIFIER (Name of the Individual shown on the ContradDr'S LiCWW)
ORIGINAL SIGNATURES ARE REQUIRED
DATE
Busim �ss Name:
Address: T U1,Az
city/statelzip: t;,. uA
Phone: —:K :z email:
nWrICF. TTQR ONIX:
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
.. _ -BUILDING & CODE REGULATIONS DIVISION-
- -- - - - -
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
(!'r0}ect ,U4= tiQm'eSS or nopeny l UA uj -Y
Xis understood that, if there. is any change of status regarding our participation with the
above mentioned project, I will immediately advise the Building.and Zoning Department
of St. Lucie County by personally filing a.Change of Contractor notice. (Form: SLCCDV
ISSUE DATE
SIGNATURE
Business Name:
Address:
City/State/Zip:
Phone:
OFFICE ITSE ONLY:
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
BUILDING PERMff
SUB -CONTRACTOR AGREEMENT
--St. Lucie County Contractor Certification Number:
State of Florida Certification Number afapplicable):
J
&__
have agreed to be the
(Company Name/�iiiiividual�
— -
- - - -- .
sub -contractor for
Awe of Trade) (Primary Contractor)
for
- (Project Street A*lresstor Property Tax ly#)
It is understood that, if there is any change of status regarding our participation with the
above mentioned project, I will immediately advise the Building and Zoning Department
of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV
No. 004-00)
BUSINESS QUALIFIER (Name of the individual shown on the Contractor's License)
ORIGINAL SIGNATURES ARE REQUIkED
PRINT NAME DATE
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
_BUILDING &CODE'REGIULATTONS DIVISION
BU"INGPERMT
SUB -CONTRACTOR AGREEMENT
PERMIT# -
7 i
Planning & Development Services Department
Building & Code Regulations Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-1553
Owner Builder Affidavit — Electrical Contracting
DISCLOSURE STATEMENT
F.S. 489.503 (6) EXEMPTIONS
State law requires electrical contracting to be done by licensed electrical contractors. You have applied for a
permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your
own electrical contractor even though you do not have a license. You may install electrical wiring for a farm
outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the
aggregate construction costs of which are under $75,000. The home or building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself
within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a
violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction
shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people
employed by you have licenses required by state law and by county or municipal licensing ordinances. Failure to do
so may result in a liability for you!
To qualify for this exemption under this subsection, an owner must personally appear and sign the building
permit application.
I hereby acknowledge that I have read and understand the above disclosure statement and that I
further understand that any violation of the terms of the owner/builder exemption shall be reported by the
Community Development Director to the Florid tate Department of Professional Regulation. Signed and
acknowledged on this _ day of , 20240L•
OWNER/BUILDER—SIGNATURF,
STATE OF FLORID
COUNTY OF !Sh .
The foregoioingg instrument was acknowledged before me this _ day of , 20
by `ir' /2r-fi A I C U� C3- JQS / W , who is personally kn n to me or
has produced
Signature of Notary
Title: Notary Public
SLCPDSD Revised 7/23/2010
A.
Print me of Notary
Commission Number
St. Lucie County Owner Builder Affidavit -Electrical Contracting
as identification.
AUDREYB.HUMPHREY
�. r"'" COMMISSION . DD 63304
°� MY 7
EXPIRES. March 6, public Undenderr+rilers
St. Lucie Count
Building & Zoning Department
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489.103 (7) EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even
though you do not have a license. You must provide direct, on -site supervision of the construction yourself. You
may build or improve farm outbuildings, a one -family or two-family residence or a commercial building at a cost of
under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially
improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within
one year after the construction is complete, the law will presume that you built or substantially improved it for sale
or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building; it is your responsibility to make sure that people employed by you
have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done.
Any person working on your building who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers'
compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, building codes, and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on how to meet
the minimum code. InitialC
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial
I understand that if I compensate any person or company for work performed they are required to be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the
cost of the license. Initial _
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical
cost, which could include loss of wages during recovery from their injury. Initial
To qualify for this exemption under this subsection, an owner must personally appear and sign the building
permit application and initial the above.
I hereby acknowledge that I have read and understand the above disclosure statement and that I further
understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and
Zoning DepartnAnt to the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of of 20.
Owner/Builder Signature
STATE OF FLORI
COUNTY OF
The -fqr-egoing instrument was acknowledged before me this day of , 20 ,
by lt�/ 1 who is personally known to me, or who has
produced as identification.
Signature of Notary Type r Print a of ary NotOtt Seal)
Title: Notary Public Commission I umber
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 3547246 OR BC; 1257 GE 1517, Recorded 01/03/2011(----�03:,' �?M
AFTER RECORDING -RETURN TO:
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement.
1. DESCRIPTION OF nPROPERTY (Legal description and street address) TAX FOLIO NUMBER:
crmnrvrcrnnr/etPd./MtJDrnrlrr TDAI rnm -2/ Dunn .,.,....
2. GENERAL DESCRIPTION OF IMI
3. OWNER INFORMATION: _ _ a
b. AddressCQS VAIA141 1A.12.4 , YO fT '3L IUCrf(. 'r V L2-1 I c interest in property 0 AM
d. Name and address of fee simple titleholder (if other than owner)
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: a 5A.Pr
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: AI fl X*E
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER: _
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified) , 20_
k
Signature of Owner or
Print Name and Provide Signatory's Title/Offlce
Owner's Authorized Otrucer/Director/Partner/Manager
StateFlor
1.
County
tyof�
The (Qregoing instrument s ackn ledged before me this
(( ,,
3 Yof u�ii , 20�LL�.
Ryrl'Qnus 6�
n
as �U111¢✓ ' rr --
(Name of person)
(Type of authority... e.g. Owner, officer, trustee, attorney in fact)
For
(Name of party on behalf f whom instrument was ex t
Personally Known
TAMECNA
r
4' I
MEIWRES�12D97 4014�
�pnwttarn�ua��
(Printed Name of Notary Public) (Signature of Notary Public)
Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and
belief (section 92.525, Florida Statutes).
Signature(s) of Owner(s) or Owner(s)' Authorized Officer/Director/Pariner/Manager who signed above:
By :��
gy_rrOnel s6UsiVi'n
Rev, etgenflW(R—.r,.&)
STATE OF FLORIDA
ST. LIME COUNTY
TH4 IS TO CERTIFY THAT THIS IS A
OR
by:
Do
CERTIFICATION: ,
This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity,
if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application.
St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such
structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply.
The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory
structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO
ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN
GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT.
r
' a.• a�
�
6
OWNER OR CONTRACTOR SIGNATURE
{ �q
�p�
STATE OF FLORIDA
COUNTY OF.
` On
The foregoing instrument was acknowledged before
o I"
me this day of 20 / i ,
&w ZC
o$
a
1
by ,1 -m c or S k i �l
CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
me this day of
by
who is personally known or. has produced- who is
. as idea 'fication.
Signature of Nota Signai
of Notary
dmowledged before
,20 ,
or has produced
as identification.
Commission No. (Seal) Con)6iission No. (Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
Adlik � - �
' 1
OFFICE USE ONLY V q R. -
SECTION
TOWNSHIP
RANGE
MAP NO.
ZONING
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
FIRM MAP #
IST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FLRS
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
Before 1/1990
LOT OF REC
After 1/1990
LOT SPLIT
REQUIRED
LOT SPLIT
APPROVED
REPORT
CODE
HABITABLE
AREA
RADON
FEE
PERMIT
FEE
LIBRARY
ROPACT
FEE
PUBLIC BLD
IMPACT FEE
CORRECTION
PUBIC BID
AVACT
FEE
GENERAL
PARKS
HvJPACT
FEE
SCHOOL
IM[PACT
FEE
ROAD
IMPACT
FEE
CREDIT
Y
N
LAW ENF
IMPACT
FEE
FIRE/EMS
H PACT
DRIVEWAY
REQUIRED
Y
N
DRIVEWAY
FEE
ADMINISTRATIVE
VARIANCE FEE
FEE
SPECIFY
SUBS
REQUIRED
MECHANIC ROOF
ELECTRIC GAS
PLUMBING
NON -CONFORMING
LOT OF RECORD
FEES
MISCELLANEOUS
FEES
DATE SENT TO ADDRESSING: ! /
•REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
INITIALS
/ �60xor.
Ole
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JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 3547787 OR BOOK 3257 —OXGE 2857, Recorded 01/05/2011 at 09( 4M
Doc Tax: $507.50
� I �
Prepared By and Return To:
Thomas Melega
Roberto & Associates Title Agency, Inc.
2151 East Commercial Boulevard, Suite 203
Fort Lauderdale, FL 33308
File No. 10-1173
Property Appraiser's Parcel I.D. (Folio) Number(s)
3415-504
C
THIS RANTY D dated cember 2010, by NGG POINy, L.L.C., a FlbZida limited liat5ility
company, w ose post office address is 3 SW 147TH AVE, MIAMI, FL 33185, hereinafter called the
grantor, to F. BEVERLEY GASKIN and DAVID M. GASKIN, wife and husband, whose post office
address is 6417 LAS PALMAS WAY, PORT ST LUCIE, FL 34952, hereinafter called the grantee:
(Wherever used herein the terms "grantor" and "grantee" include all the parties to this
instrument and the heirs, legal representatives and assigns of individuals, and `the
successors and assigns of corporations)
WITNESSETH: That the grantor, for and in consideration of the sum of $72,500.00 and other valuable
consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens,
remises, releases, conveys, and confirms unto the grantee, all the certain land situated in St. Lucie
County, Florida, to wit:
L 1, Las Pa na , accor ' g to the map or plqfthereof, as red r lled n Plat B ok 46
TO HA�EAND TO HOLD th sa�eiv Fee Sii
AN tantor hereby cov noith said
fee imthat the an r h sd rightj
all pers whoms er; and tha
subsequent to: December 31, 2010
werrany ed (India "madM) co
�ne that he�thee
awfullyseized f s id land in
ulut oritnd conveyhe
w' defeagainst a lawful clai of
is freences, exc ing
1 \
OR BOOK 3257 PAGE 2858
WARRANTY DEED
(Continued)
IN WITNESS WHEREOF, the said grantor has signed and sealed these presents the day and year first
STATE OF FLORIDA
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W.,..
(Address)
MIAMI, FL 33185
(Address)
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ody 2 10 an a knowlelisy f Dece b r, 2010.
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